Persistent uncontrolled severe asthma despite widespread biologic use: care gaps from the French FASE2-CPHG...

Area of Science:

• Pulmonology
• Real-world evidence
• Severe asthma management

Background:

• Biologic therapies have advanced severe asthma care, but real-world data often comes from specialized centers.
• Many patients in routine care settings continue to experience symptomatic disease despite available treatments.

Purpose of the Study:

• To assess disease control, exacerbations, adherence, comorbidities, and care gaps in adults with severe asthma in French non-academic hospitals.
• To evaluate the real-world effectiveness of biologic therapies in a broad patient population.

Main Methods:

• A national, multicenter, cross-sectional study (FASE2-CPHG) involving 970 adults with GINA Step 5 asthma.
• Data collected via physician electronic forms and patient questionnaires (ACT, HADS, Ricci & Gagnon).
• Included assessment of clinical characteristics, biomarkers, imaging, exacerbations, and biologic treatments.

Main Results:

• 71.2% of patients received biologic therapy, yet 59.8% had uncontrolled asthma (ACT).
• 62.6% experienced at least one exacerbation in the prior year; only 31.6% reported full adherence.
• High prevalence of anxiety (45.6%) and depression (24.6%) noted, alongside significant comorbidity burden.

Conclusions:

• Biologics are common in non-academic settings, but a majority of severe asthma patients remain uncontrolled.
• Significant care gaps exist, including unrecognized poor adherence, psychological and physical comorbidities, and suboptimal inhaled therapy.
• Addressing these gaps could improve outcomes comparably to introducing new biologic agents.